NPIMap

Individual provider Active NPI

Theresa J. Campbell, FNP

  • Family Nurse Practitioner
  • Fayetteville, NC
National Provider Identifier
1841246501
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201393 Issued in NC
Practice address
557 Sandhurst Dr
Fayetteville, NC 28304-4433
Phone
(910) 484-8114
Fax
(910) 484-1564
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201393 NC Primary

Addresses

Primary practice location

557 Sandhurst Dr
Fayetteville, NC 28304-4433

Mailing address

557 Sandhurst Dr
Fayetteville, NC 28304-4433
Phone (910) 484-8114

Other identifiers 1

IdentifierTypeStateIssuer
7000226MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070711000471 NC Practitioner - Nurse Practitioner 7719087360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Kidney Care PAGroup PAC ID 4587576020, 24 clinicians

Practice addresses (Care Compare)

557 Sandhurst Dr
Fayetteville, NC 28304-4433
Phone (910) 484-8114

Hospital & facility affiliations

  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028

Merit-based Incentive Payment System (MIPS)

Final score
91.91 of 100Reported as group
Quality
60.8
Promoting interoperability
100
Improvement activities
40
Cost
86.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Kidney Care, PA CurrentSince Oct 26, 2013 Accepting new patients
Metrolina Nephrology Associates, PA Current Accepting new patients

Locations

2711 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 342-1900

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

557 Sandhurst Dr
Fayetteville, NC 28304

2544 Court Dr
Ste F
Gastonia, NC 28054
Phone (704) 864-8302

810 Wesley Pines Rd
Lumberton, NC 28358
Phone (910) 618-1055

Interoperability endpoints

  • Direct secure messaging: tcampbell17195@direct.acumenmd.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1841246501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 SANDHURST DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044433",
            "telephone_number": "910-484-8114",
            "fax_number": "910-484-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 SANDHURST DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044433",
            "telephone_number": "910-484-8114",
            "fax_number": "910-484-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "THERESA",
        "middle_name": "J.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000226",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.